Increased splenic density

Changed by Bram Miseur, 6 Sep 2017

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Increased splenic density can be due to a number of processes. The density may be due to calcification (most common) or other compounds (iron, Thorotrast), and can be seen (often incidentally) on abdominal radiographs and CT. On CT the usual splenic attenuation is 35-55 HU or ~10 HU ⁶lower than the liver.

Pathology

Aetiology

Splenic calcification

localised splenic calcification:
- haemangiomata
- splenic infarcts ¹
- cysts
  - hydatid: common
  - congenital, epidermoid and dermoid cysts: rarely calcify ⁵
- splenic haematoma ⁴, e.g. post traumatic
multiple focal calcification
- granulomas ^1-2: typically measure 1-10 mm in size

See splenic calcification article for more information.

Diffuse hyperdensity

lymphoma
sickle cell disease
iron deposition
- sickle cell anaemia: up to 5% of cases the spleen will be increased in density, either homogeneously or with a course granular appearance ⁴due to iron within siderotic nodules
- haemochromatosis ^4-5
- Fanconi's anaemia
Thorotrast accumulation ⁴
amiodarone toxicity 7

Splenic capsule calcification

Deposition of calcium salts in on the surface of the spleen is associated with perisplenitis, secondary to peritonitis.

Differential diagnosis

splenic artery
- atherosclerosis of the splenic artery is very common, and may be discontinuous and partially overly the spleen ¹
- splenic artery aneurysms may have calcified walls ³

On plain radiograph, consider other causes of abdominal calcification:

pancreatic calcification as seen in chronic pancreatitis
adrenal calcification
costochondral calcifications
nephrolithiasis

~~-</ul><p>See <a title="Splenic calcification" href="/articles/splenic-calcification">splenic calcification</a> article for more information. </p><h6>Diffuse hyperdensity</h6><ul>~~
+</ul><p>See <a href="/articles/splenic-calcification">splenic calcification</a> article for more information. </p><h6>Diffuse hyperdensity</h6><ul>
+<li>amiodarone toxicity <span style="font-size:10.8333px">7</span>
+</li>

References changed:

7. Kuhlman JE, Teigen C, Ren H et-al. Amiodarone pulmonary toxicity: CT findings in symptomatic patients. Radiology. 1990;177 (1): 121-5. <a href="http://radiology.rsna.org/content/177/1/121.abstract">Radiology (abstract)</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/2399310">Pubmed citation</a><div class="ref_v2"></div>

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